<!DOCTYPE html>
<html>
<head>
<meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1">
<style type="text/css">
	p { font-family: sans-serif; }
	textarea { width: 25em; height: 15em; }
</style>
<title>#32</title>
<script type="application/javascript" src="../lib/fastclick.js"></script>
<script type="application/javascript">
	window.addEventListener('load', function() {
		new FastClick(document.body);
		Array.prototype.forEach.call(document.getElementsByClassName('button'), function(button) {
			button.addEventListener('click', function(event) {
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			}, false);
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</head>
<body>
<div class="appt-search-form no-height">
	<div class="fancy">
		<input type="hidden" class="apptPatient" name="patient" value="5004" data-shadow="false">
		<div class="ui-hide-label">
			<label for="apptType" class="ui-select">Appointment Type</label>
			<div class="ui-select">
				<div data-corners="true" data-shadow="false" data-iconshadow="true" data-wrapperels="span" data-icon="th-list" data-iconpos="right" data-theme="a" class="ui-btn ui-btn-corner-all ui-btn-icon-right ui-btn-up-a">
					<span class="ui-btn-inner ui-btn-corner-all">
						<span class="ui-btn-text">
							<span class="apptType">Appointment Type *</span>
						</span>
						<span class="ui-icon ui-icon-th-list ui-icon-shadow">&nbsp;</span>
					</span>
					<select class="apptType" name="apptType" id="apptType" data-shadow="false" data-icon="th-list">
						<option value="-1" data-placeholder="true">Appointment Type</option>
						<option value="5000">Sick Visit</option>
						<option value="5509">9 months Well Visit</option>
						<option value="5512">1 year Well Visit</option>
						<option value="5515">15 months Well Visit</option>
						<option value="5518">18 months Well Visit</option>
					</select>
				</div>
			</div>
			<label for="apptCalendar" class="ui-select">Physician</label>
			<div class="ui-select">
				<div data-corners="true" data-shadow="false" data-iconshadow="true" data-wrapperels="span" data-icon="user-md" data-iconpos="right" data-theme="a" class="ui-btn ui-btn-up-a ui-btn-corner-all ui-btn-icon-right">
					<span class="ui-btn-inner ui-btn-corner-all">
						<span class="ui-btn-text">
							<span class="apptCalendar">Physician</span>
						</span>
						<span class="ui-icon ui-icon-user-md ui-icon-shadow">&nbsp;</span>
					</span>
					<select class="apptCalendar" id="apptCalendar" data-shadow="false" data-icon="user-md">
						<option value="-1" data-placeholder="true">Physician</option>
						<option value="-1">Any</option>
						<option value="5000">Dr. Jim</option>
						<option value="5001">Dr. Wixler</option>
						<option value="5002">Anya</option>
						<option value="5003">Jada</option>
					</select>
				</div>
			</div>
			<label for="dateAfter" class="ui-input-text">Date</label>
			<input class="dateAfter ui-input-text ui-body-a ui-corner-all ui-shadow-inset" id="dateAfter" type="date" data-icon="calendar">
			<label for="apptTimeWindow" class="ui-select">Time of Day</label>
			<div class="ui-select">
				<div data-corners="true" data-shadow="false" data-iconshadow="true" data-wrapperels="span" data-icon="time" data-iconpos="right" data-theme="a" class="ui-btn ui-btn-up-a ui-btn-corner-all ui-btn-icon-right">
					<span class="ui-btn-inner ui-btn-corner-all">
						<span class="ui-btn-text">
							<span class="apptTimeWindow">Time of Day</span>
						</span>
						<span class="ui-icon ui-icon-time ui-icon-shadow">&nbsp;</span>
					</span>
					<select class="apptTimeWindow" id="apptTimeWindow" data-shadow="false" data-icon="time">
						<option value="0" data-placeholder="true">Time of Day</option>
						<option value="0">Any</option>
						<option value="1">Morning</option>
						<option value="2">Afternoon</option>
						<option value="3">Evening</option>
					</select>
				</div>
			</div>
		</div>
	</div>
	<span class="search btn-success">
		<div data-corners="true" data-shadow="true" data-iconshadow="true" data-wrapperels="span" data-icon="null" data-iconpos="null" data-theme="a" class="ui-btn ui-shadow ui-btn-corner-all ui-btn-up-a" aria-disabled="false">
			<span class="ui-btn-inner ui-btn-corner-all">
				<span class="ui-btn-text">Find Appointments</span>
			</span>
			<button class="btn-success ui-btn-hidden" aria-disabled="false">Find Appointments</button>
		</div>
	</span>
</div>
</body>
</html>